Tablet Presentation

Each Uncoated Tablets Contains:
Telmisartan IP 40 mg
Hydrochlorothiazide IP 12.5 mg
Amlodipine Besylate IP Equivalent to Amlodipine 5 mg

Telmesartan is used in combination with hydrochlorthiazide, amlodipine to treat hypertension and reduce the risk of stroke in patients with left ventricular hypertrophy and hypertension, kidney problems .

Theraupeutic Indication

• Used in treatment of edema associated with congestive heart failure
• In hypertension.

About Composition

Telmesartan:

Telmesartan is the angiotensin 2 receptor blocker to treat hypertension . It is used to treat diabetic nephropathy in patients with type 2 diabetes mellitus. Telmesartan improves the carbohydrate as well as lipid metabolism.

Hydrochlorothiazide:

hydrochlorthiazide is the thiazide diuretic . It treats edema and hypertension.

Amlodipine:

Amlodipine is the calcium channel blocker which blocks the calcium channel. It belongs to the class of dihydropyridine calcium channel blocker. It lowers the incidence of myocardial depression.

Mechanism of action

Hydrochlorthiazide prevents the reabsorption of the sodium and water from the distal convoluted tubule by inhibiting the sodium chloride symporter and allowing the water excretion via urine . Telmesartan competitively blocks the AT1 receptor present in the smooth muscles and adrenal gland from binding with angiotensin 2 ( vasoconstrictor) therefore prevent the synthesis of aldosterone and angiotensin 2 mediated effect i.e relaxation of vascular smooth muscles and lowers the blood pressure. Amlodipine: It inhibits the influx of calcium channel into the vascular smooth muscle and cardiac muscle. Amlodipine dilates the peripheral arterioles , reduces the peripheral resistance.

Pharmacokinetics

Telmesartan:

Absorption - It is orally absorbed and its bioavailability decreases with administration of the food.
Protein binding - It is highly protein bound upto 99.5%, mainly to albumin
Metabolism - It undergoes glucuronide conjugtion.
Excretion - It is excreted via urine

Hydrochlorthiazide:

Absorption - It is orally absorbed
Protein binding - It is about 40 to 60% protein bound
Metabolism - Hydrochlorthiazide is metabolized in the liver.
Excretion - It is excreted unchanged in the urine

Amlodipine:

Absorption - It is absorbed from the GIT
Protein binding - It is about 98% bound to plasma proteins
Metabolism - It is metabolized in the liver.
Excretion - It is excreted in the urine.

Side effects

• Muscle stiffness
• Tremors
• Muscle twitching
• shortness of breath
• Tiredness

Contraindications

• It in patients with known hypersensitivity
• It is contraindicated in pregnant women

Storage

It is stored at cool and dry place